Substance(drug) abuse disorders- general part I Substance(drug) abuse disorders- general part I
Substance abuse: It is a persistent use of one or more psychoactive substance. Dependence (addiction): untreated, persists and progresses, it ends in dependence: craving, tolerance, withdrawal symptoms, social and personal decline.medical complications .
Craving: a strong and an irresistible desire. Tolerance: more amount of the drug to obtain the same effect (dose escalation). Physical dependence: withdrawal syndrome. Psychological dependence: urge to use the drug, thinks about it, likes it and he can not abstain.
Personality factors: Predisposition to experiment with both licit and illicit drugs is more likely in those with sensation-seeking or impulsive behaviour traits, and in extroverts rather than in introverts. Herditary factors: alcoholic father. Age: Adolescence and puberty
How abused drugs affect the brain? primary neurotransmitter:glutamatestimulatory ,gamma amino butyric acid(GABA) inhibitory, appropriate balance . Secondary transmitters:dopamine, serotonin, noradrenalin, acetylcholine, endogenous opiates, emotion to the primary processes. All drugs act by interfering with these neurotransmitters.
Types according to the ICD-10: Alcohol, opiates, cannabinoids, sedatives (benzodiazepines and barbiturate), Stimulants (caffeine, amphetamine),cocaine, hallucinogens, nicotine , volatile substances (adhesives, aerosols, fuel gases, paints,multiple
1.Risk route of use: infection (hepatitis ,HIV), increased rate of brain entry,opiateintox. respiratory depression 2.Risk of the drug itself. 3.Addictiveness : opiates,cocaine. A. pleasure.b. physical suffering of abstinence.c.the psychological suffering, drug to relieve symotoms. 4. Ease of stopping.
Management 1. precontemplation stage: there is no recognition of a need for treatment. 2. contemplation stage: treatment is being considered, the patient is helped to clarify his views and to build his motivation to change. 3 .Decision and action stage